Background and objective: The current literature describing the use of minimally invasive autopsy in clinical care is mainly focused on the cause of death. However, the identification of unexpected findings is equally important for the evaluation and improvement of daily clinical care. The purpose of this study was to analyze unexpected post-mortem computed tomography (PMCT) findings of hospitalized patients and assess their clinical relevance. Materials and methods: This observational study included patients admitted to the internal medicine ward. Consent for PMCT and autopsy was requested from the next of kin. Decedents were included when consent for at least PMCT was obtained. Consent for autopsy was not obtained for all decedents. All findings reported by PMCT were coded with an International Classification of Diseases (ICD) code. Unexpected findings were identified and subsequently categorized for their clinical relevance by the Goldman classification. Goldman class I and III were considered clinically relevant. Additionally, correlation with autopsy results and ante-mortem imaging was performed. Results: In total, 120 decedents were included and evaluated for unexpected findings on PMCT. Of them, 57 decedents also underwent an autopsy. A total of 1020 findings were identified; 111 correlated with the cause of death (10.9%), 508 were previously reported (49.8%), 99 were interpreted as post-mortem changes (9.7%), and 302 were classified as unexpected findings (29.6%). After correlation with autopsy (in 57 decedents), 24 clinically relevant unexpected findings remained. These findings were reported in 18 of 57 decedents (32%). Interestingly, 25% of all unexpected findings were not reported by autopsy. Conclusion: Many unexpected findings are reported by PMCT in hospitalized patients, a substantial portion of which is clinically relevant. Additionally, PMCT is able to identify pathology and injuries not reported by conventional autopsy. A combination of PMCT and autopsy can thus be considered a more comprehensive and complete post-mortem examination.

中文翻译：

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住院患者病后计算机断层扫描的意外发现的临床意义：一项观察性研究

背景与目的：当前描述微创尸检在临床护理中使用的文献主要集中在死亡原因上。但是，发现意外发现对于评估和改善日常临床护理同样重要。这项研究的目的是分析住院患者的意想不到的验尸计算机断层扫描（PMCT）结果并评估其临床相关性。材料和方法：这项观察性研究包括入住内科病房的患者。从近亲处要求同意PMCT和尸检。当获得至少PMCT的同意时，包括后代。未获得所有后裔的尸检同意。PMCT报告的所有发现均以国际疾病分类（ICD）代码进行编码。识别出意外的发现，然后根据高盛分类对它们的临床相关性进行分类。高盛I级和III级被认为具有临床意义。此外，还进行了与尸检结果和验前成像的相关性分析。结果：总共包括120名死者，并对PMCT的意外发现进行了评估。其中，有57名死者也接受了尸检。总共确定了1020个发现；与死亡原因相关的有111个（10.9％），先前报告有508个（49.8％），99个被解释为验尸变化（9.7％），302个为意外发现（29.6％）。与尸检相关（57例死者）后，仍有24例临床相关的意外发现。这些发现在57名死者中有18名（32％）被报告。有趣的是，所有意外发现中有25％没有通过尸检报告。结论：PMCT在住院患者中报告了许多意想不到的发现，其中很大一部分与临床有关。此外，PMCT能够识别常规尸检未报告的病理和损伤。因此，将PMCT和尸检结合起来可以认为是更全面和完整的验尸检查。